Certainly there are egregious situations in which meds may be appropriate. I believe, however, that such situations are so infrequent that pointing to them as a shining lighthouse in the dark is dishonest because it begins to lower the bar and promote medication where it should not occur.

Here's EXACTLY the kind of example that i'm talking about, where we are supportive to the self-medicated person which then promotes further unnecessary medication:

Brooke Shields had some post-partum depression problems. She got medicated. Everyone lauded (before the Tom Cruise thing) how "brave" she was for coming out and admitting her problem and seeking help, i.e. medicated help. Having just gone through child-birth with my wife, and having been the recipient of a "high-needs" baby (i.e. cries WAY more than normal babies, up all the time, not sleeping through the night, long, fitful crying bouts all day long, etc. etc.), I am well aware of the toll this takes on the mother. Mom is simultaneously conflicted with feelings of love for the baby, but also severe frustration that makes her want to throw the baby out the window. This contradiction kinda makes mom go crazy, and she gets very depressed. It happened to my wife.

Now look back at Brooke Shields. Because we all praised her for getting medicated, the lesson to the average person having the kind of problem I describe above is "get mom hooked up on post-partum depression drugs". That message is an absolute SIN and Brooke Shields is partly to blame for promoting such a message. The more healthy thing to do, what my wife and i did, was talk about her depression, talk about her conflicting feelings of love and hate for the baby, talk about the rising frustration that builds up throughout the day with a baby that simply cannot be consoled and that will not stop crying. But people don't want to do this because it's hard work and is confessional in nature. It forces you to confront a scary truth - on some subconscious level I really do hate my baby. THAT is the frightening truth lying at the core of a lot of post-partum depression issues. But no mother, and no father, wants to take on the difficult introspective task of admitting this ghastly truth and dealing with it honestly. It's much easier to avoid this hard work (what i call 'lazy') and to be fearful of confronting this hard truth (what i call 'cowardly') and just deny all responsibility by calling it a chemical imbalance.

It is an absolute fraud to characterize this situation as a "chemical imbalance". Anyone who's been through it can clearly see that the underpinnings of mom's depression in cases like this (like the one i went through w/ my wife and son) are psychological in nature, are caused by the extreme pressures of highly frustrating circumstances involving deep emotions of simultaneous love and hate for one's newborn. To delude oneself into believing this is merely a "chemical imbalance" is to ignore the true underlying problem, and to simply paint a happy face on top of an underlying volcano waiting to explode at some point in the future.

Are there SOME moms SOMEWHERE with situations SO extreme as to require medication? Sure. But when we praise people like Brooke Shields for medicating her psychological problems then we encourage others NOT to face the underlying psychological issues, and instead just whitewash the issue away with drugs. That is wrong on so many levels.

It would be interesting to go around and around with this... Unfortunately, we end up in a battle of extremes and I'm also not nearly prepped for class! Most people would agree we toss too many pills around and often medicate when its not necessary. As a former elementary school teacher, I'm well aware of parents who can't be inconvenienced by an energetic and high energy child. The other side of the coin is a set of parents (one of whom chose to stay at home and aid in the child's classroom during all school hours) doing EVERYTHING at their disposal to help their child. They barely sleep, neighbors won't let their kids play at their house, the child has a bad rep at school, and they spend 24 hours a day trying to out think a child that WILL eventually hurt someone or something. Again, until it is your home/your child...and you try for years as you watch your friendless wounded child develop greater emotional complications because they just can't slow down enough to put some forethought into their actions... saying things like, "walk in the woods" and "go play so more catch"....honestly makes you part of the problem. People do have genetic tendencies, do they all need pills? Of course not. Tex also made reference to not being associated with these people because of their life attitudes (I believe lazy or something to that effect), NEWSFLASH there are people around you who value your friendship, think you are a smart guy, and know how you feel about mental illness... they just hide their problems/scrips from you.

I DON'T ADVOCATE PEOPLE RUNNING TO THE DOC WHEN THEIR LIFE IS NOT PERFECT. IF THE CHOICE IS BEING MISERABLE, HURTING THEMSELVES, AND OTHERS... let them have the meds. In the mean time, if this is really an "issue" and you want to truly help, use your d**mn T-14 degrees to separate the doctors from the drug companies. Get the bean counters at the HMOS to stop advocating meds instead of more expensive treatment. Truth is until it happens to most people, they won't do a thing. There is no money in it....why help the lazy anyway?

Bradzwest - here's the problem. Everyone agrees with the platitudes that "Americans are too medicated" and "Americans jump to quick fix solutions in the form of pills and ignore the underlying problems". Sure, everyone agrees with these easy-to-rattle-off truisms in the abstract. The problem is that every time an actual example of self-medication ever arises either in the media or in personal conversations, everyone ALWAYS says "oh, that's different, this guy/gal REALLY does need the drugs". It's as if we recognize the general problem but are completely unwilling to actually point to any example offenders.

That's where I part company with those mouthing the platitudes. I'm willing to actually point to specific people (e.g Brooke Shields), specific examples, and condemn them as lazy & cowardly (i use those terms technically as described above b/c there do not seem to be non-pejorative substitutes) examples of self-medicated people escaping the underlying psychological truth. What I object to is the fact that we all agree to the platitudes you've mentioned, but simultaneously decry as taboo any attempt to hold actual individuals accountable for their choice to self-medicate. Without license to do the latter, the platitudes are just that - meaningless phrases we all mouth in unison.

Herein lies the devil of it all, at least for the time being. But also, I see no reason why TV commercials for prescription drugs should be tollerated. If we accept that drugs are powerful, that they all have side effects, and that people must see a doctor to get a prescription, these ads are dangerous. They give unprecedented power to companies that have both the government and doctors on their side. Which side does that leave patients on? Why, the side of a consumer, of course. When, exactly, did "consumer" become synonymous with "patient?" What are the consequences?

I'll admit, part of what makes people hostile to me is that, basically, i'm a misanthrope. Don't have a lot of faith in people once more than 3 or 4 of them congregate together.

I know that right now, it might sound like SciFi craziness, but i'm convinced that we're headed toward a future resembling a cross between Brave New World and Gattica - a world where the beauty of the individual human spirit fighting valiantly against the slings and arrows of life's misfortunes is replaced with a new goal in which technology and innovation are no longer tools for emblazoned demonstrations of the human spirit, but become ends in themselves. People will be medicated because it's more efficient. The next generation is genetically engineered because we can. In this world, the insane person becomes the one who still clings to that flame of individual human spirit, the one who relinquishes society's least common denominator of blue-pill happy efficiency and instead chooses a sober life of mistakes, creativity, learning, self direction, and yes - very possibly failure and self destruction. To save us from ourselves, we will destroy ourselves by ceasing to be human.

Wow, BigTex, it's really impressive how you can take your limited experience with your wife's post-partum depression and assume that what was true for her is true for everyone else. That kind of massive, unwarranted generalization from your own limited experience seems pretty irresponsible, especially for someone who's going to be a lawyer one day. Your presumption that what worked for your wife must, by definition, work for everyone, and that if it doesn't then they are by definition lazy, is ridiculous. Being judgmental and self-righteous is pretty bad on its own, but add being deeply and unapologetically ignorant to the mix and you've got a real loser on your hands. Sorry about that. But at some point, people like you tend to realize - often painfully - that they don't have everything all figured out after all.

Oh, and for the people ruminating on how clinical depression is a "luxury for the upper classes" or whatever that crap was, look up some statistics. Depression is most common by far in lower socioeconomic groups.

Wow, BigTex, it's really impressive how you can take your limited experience with your wife's post-partum depression and assume that what was true for her is true for everyone else. That kind of massive, unwarranted generalization from your own limited experience seems pretty irresponsible, especially for someone who's going to be a lawyer one day.

Yeah, kinda like how all of the media assumed that post-partum drugs are the right thing for anyone having severe post-pregnancy depression after Brooke Shields came out w/ her personal story of drugged salvation.

If you've read my posts with any fairness, you'll see that my point of contention is not that there are some subset of people legitimately using drugs, but that getting medicated is now viewed as the default/normal response to mental problems. While this latter statement is generally agreed to in the abstract, i've also pointed out that there is general condemnation if anyone actually applies this generally agreed-to truism to any particular case. As long as you attack me for things i'm not saying it just reinforces my belief that the problem is as deep and pervasive as i've described. Or perhaps you too agree with the general principle (americans are too medicated) and yet still cling to the taboo about actually calling anyone on it?

Some professors are helping their students march through law school with their values and self-esteem intact—en route to becoming happier lawyers

by Jane Easter Bahls

If you're a typical law student, you may be feeling depressed and disconnected from what you used to believe. But don't take it personally, and don't despair even further. Research shows you're far from alone, and there are simple things you and your professors can do about it.

That's the gist of the gospel from a small but energetic movement within legal academia to "humanize" the law school experience. Adherents are not only documenting a high degree of depression among law students and lawyers. They're also working to alleviate it by encouraging students to get in touch with their core values.

Studies finding unusually high levels of distress among law students and lawyers lend evidence to the reformers' efforts. Research by psychologist Andrew Benjamin, for instance, showed that significant numbers of law students at the University of Arizona were psychologically healthy when they arrived, but within the first year developed major psychological distress that remained through law school and into the graduates' careers. Anxiety, hostility, and depression ran eight to 15 times higher than in the general population.

Even though that study was conducted in 1986, many within the humanization movement consider it valid based on the soundness of the research, similar findings among lawyers, and anecdotal and empirical evidence from today's students.

Numerous studies have shown that lawyers, however prosperous they may be, are a relatively unhappy lot. For example, a 1995 study by psychologist Connie Beck and her colleagues found that 20 percent to 35 percent of the lawyers studied reported symptoms associated with being clinically distressed—at a level found in only about 2 percent of the general population.

A recent empirical study by Florida State University law professor Lawrence Krieger and University of Missouri-Columbia psychology professor Kennon Sheldon, published as a summary in the March/June 2002 Journal of Legal Education, measured students’ motivations, values, and "subjective well-being," a term that emcompasses levels of good and bad moods and life satifaction.

Law students in the study began with higher subjective well-being than comparison samples of undergraduates and other new professional students, but by the end of their first year that had plummeted. Meanwhile, the law students became more motivated by externals—grades, appearances, money—and less by intrinsic values such as personal growth and contribution to the community.

Not that making money and being respected is inherently bad, Krieger says. The point, he emphasizes, is one that psychological research backs up: People whose primary motivation is money tend to be unhappy, while people who are motivated by goals such as helping others or making a difference tend to be happy. In Krieger and Sheldon’s study, many who started law school in hopes of serving the public had given up their dream in favor of money and prestige.

"Perhaps ironically," Krieger says, "research shows that the general distress and depression among law students is not mitigated by high grades, nor is dissatisfaction among lawyers mitigated by high salaries."

Clearly, something’s wrong. "Lawyers tend to ignore their inner lives," says journalist Steven Keeva, an assistant managing editor at the ABA Journal and author of Transforming Practices: Finding Joy and Satisfaction in the Legal Life (Contemporary Books, 1999). "They are consummate doers, trying to control things, win, take care of things."

Again, that's not bad in itself, but Keeva found through dozens of interviews that lawyers tend to be psychologically one-sided—and that they became that way soon after starting law school. He explains that the primary thrust of legal education—teaching students how to think like a lawyer—is so pervasive that students and lawyers alike find themselves analyzing everything in their lives, at the expense of relationships, values, and spirituality. And when they feel the loss of things they used to hold dear, they typically keep their feelings bottled up. "There's a code of silence in the profession," Keeva says. "There's this fear of looking soft."

Those who pay attention to these issues say most law professors and administrators appear to be ignoring the problems. Others are skeptical of the supporting studies or find the whole effort flaky.

But the movement to humanize legal education—a community of law professors scattered across the nation—has been studying these issues, publishing articles on the topic, and helping students regain some perspective. They say you don't have to wait for major changes in legal education. Thinking about values and priorities now—and talking about them with other students—can help you maintain your equilibrium in law school and throughout your career.

The movement's linchpin is Krieger, clinical professor and director of externships at Florida State University College of Law. Having taught stress management both before and after becoming a lawyer, Krieger noticed how tense his law students were. "I realized these people were very insecure," he recalls.

Krieger related their feelings to psychologist Abraham Maslow's hierarchy of needs: how people must meet the basic needs for survival, security, belonging, and respect before they move toward contentment. But from the earliest days of law school, he says, students get the message that they must make top grades, must perform flawlessly in class, and must compete with other students. In effect, law students have to worry about survival, security, and whether they really belong. Many panic.

"I was very aware of the emotional health problems of lawyers," Krieger says. "How much of that starts in law school? How much of it could we head off if we taught them healthy perspectives?"

He began teaching students in his classes about Maslow’s hierarchy and getting them to talk about their needs and fears. Nearly all of them defined success in law school as being in the top 10 percent, which means that 90 percent are set up for failure.

"I was a litigator for a long time, and I never had a judge ask me what my class rank was," Krieger says. "Ninety percent of our students have a legal job within six months of graduating—but our students don;t know that."

Krieger reminds students that only a tenth of them can be in the top 10 percent, but nearly all will survive law school and get decent jobs. Top students get first crack at big-firm interviews—but is that worth sacrificing your health and relationships for three years? Many of his students report that it helped tremendously just to put it all in perspective.

Exchanging ideas and support

Krieger now manages a listserv for about 230 law professors and others interested in these issues, to exchange ideas and mutual support. One member is Daisy Hurst Floyd, a professor at Texas Tech University School of Law. Floyd engaged students in a Carnegie Foundation project on professional identity, where students in her seminars read and discussed readings, listened to visiting lawyers, wrote reflective essays, and participated in a web-based discussion board.

Floyd and her students agreed that law school does an excellent job of teaching students to think like lawyers. However, the students also reported competition among students so intense that many classrooms were actively hostile. Those who couldn’t attain the prizes of top grades and law review suffered feelings of failure and inadequacy.

"Students were talking to each other about feelings of isolation," Floyd says. "They'd felt they couldn’t talk about it before." She notes that it's natural to have some doubts about a position with as much responsibility as being a lawyer, "but we were sending signals that if you feel doubt, maybe you’re not cut out for it."

While the practice of law is about relationships, Floyd explains, legal education devalues relationships and other emotional matters. "It is not just that we fail to teach students about relationship skills," she says. "Legal education actually diminishes or eliminates the ability to form and sustain relationships that students possess when they begin law school."

Floyd observes that most students enter law school with a clear sense of purpose and a passion to do something important, but they soon find that their passion isn't even addressed. Appellate cases, the staple of first-year study, focus far more on legal issues than on the people involved. The idea that lawyers help clients—real people with real problems—drops off the radar screen.

"Students think they were wrong about what law is all about," she says. "They think their initial vision was naive, so they have to give it up." That leads to a deep sense of loss and a numbing resignation to the system.

A related movement called "therapeutic jurisprudence" is addressing those issues by seeking to make people's experience with the legal system supportive and healing rather than traumatic and stressful, as it often is. Led by law professors David Wexler of the University of Puerto Rico and Bruce Winick of the University of Miami, proponents focus on cooperation, communication, and being sensitive to a client's personal issues.

"If it weren't for David Wexler, I would have been totally discouraged and depressed," says Puerto Rico third-year law student Adi Martinez, who finds legal analysis mechanical and dull. "Therapeutic jurisprudence is about talking to the client, not just doing whatever the client wants." That perspective, she says, has helped her keep her chin up in more traditional classes.

Floyd contends that the best way to help students is to give them permission and opportunities to engage in two activities generally devalued in law school: reflection and connection. Writing reflectively helps them understand why they've experienced law school the way they have. Connecting with other students on an emotional level can be a relief, as students discover they're not alone in their feelings. So can connecting with lawyers who've achieved balance and found meaning in their lives.

Just ask Richard Chapman, newly graduated from American University's Washington College of Law. "Law school is a very lonely process," he says. "Even though you’re around people all the time, you don’t get in touch." In an externship class with professor Marlena Valdez, another listserv member, Chapman read and discussed articles on how being a lawyer fits into your spiritual being. "Her class really made me think about why I was going to be a lawyer," he says. "We all felt we were detached from people, and appreciated being able to get in touch."

Is all this too touchy-feely for legal education? Some critics think so. Professor Barbara Glessner Fines of the University of Missouri-Kansas City reports that some faculty members equate humanizing legal education with lowering standards. "If you talk about lowering expectations, they say you're coddling into the profession people who aren't cut out for it," she says. "They say, 'If you can't take the heat, get out of the kitchen.' But why can't you put a fan in the kitchen?"

Even schools that attract the brightest legal minds in the nation could use a fan in the kitchen. A student essay in the Harvard Law Review in 1998 reported that by the second year, "a surprising number of Harvard Law students resemble 'the walking wounded': demoralized, dispirited, and profoundly disengaged from the law school experience. What's more, by third year, a disturbingly high number of students come to convey a strong sense of impotence and little inclination or enthusiasm for meeting the world's challenges head on."

Krieger assigns the essay (Making Docile Lawyers: An Essay on the Pacification of Law Students) to his students to read. He estimates that more than 90 percent indicate their experience is similar.

There's hope, even at Harvard. Professor Todd Rakoff, dean of Harvard's J.D. program, reports that the school's emotional culture is changing. During the past 30 years, he notes, the student body has become more attuned to the emotional side of the classroom. That calls for a different approach to teaching.

"The older-school professors believed that first year should be like boot camp— tough as nails, and professors should never be nice to students," he says. "Harvard has been making efforts to move away from that." Legal education must be rigorous, he says, but it's really important to look at the psychodynamics of the classroom.

Outright resistance to the humanizing movement isn't its biggest challenge. Krieger contends that the larger challenge is institutional denial—faculties and deans not even acknowledging that there's a problem, despite the growing body of empirical and anecdotal evidence. "The problem is no one is reading the articles," Krieger says in frustration. He says there's little evidence that more than a few law professors are aware of the problems he's addressing.

More will soon. The Association of American Law Schools Section for Student Services has scheduled a major program at the association's annual meeting in January on depression and distress among law students and what to do about it. Deans of students from across the country will be discussing these issues and seeking solutions.

What are the solutions? Even those most familiar with the problems don't have it all worked out; many are still grappling with possible causes. Krieger makes three suggestions for institutional change.

One is for law schools to reconsider the practice of making students work exceptionally hard. "Persistently long hours of high-demand work obviously drains personal resources," he says. The endless hours of nothing but legal study displace other things people need to be doing to remain psychologically healthy.

A second is to stop communicating to students that they're only succeeding if they rank in the top 10 percent, that failing to do so jeopardizes their future employment, and that personal character, values, and ideals are now largely irrelevant. "One could hardly design by intention a more effective belief system for eroding self-esteem," he says.

Third, he contends that schools should back away from the mandatory or "strongly suggested" grade curve that must include a certain percentage of D’s. Under this system, no matter how narrow the spread between the top exam and the bottom one, those on the bottom must be D's. That further demoralizes students for no good reason, he says.

Whether or not they're likely to see institutional change, certain law professors are helping students examine these issues in and out of class. For instance, professor Laurie Morin, who teaches professional responsibility at the University of the District of Columbia law school, has students write for five minutes at the beginning of every class, reflecting on what they're learning and how it relates with their own beliefs. Then they talk about it. Students are initially skeptical, she says, because they're being asked to deal with the personal values that law school tries to drum out of them. Once they get beyond that, she says, "They get so excited. No one else asks them about what they're feeling."

Morin advises law students to do this on their own, whether or not a professor requires it. "Remember why you went to law school in the first place," she says. "Write it down. Ask yourself every day how what you’re doing is related to that reason."

Florida State law graduate Jeff Schumm, a former student of Krieger’s who is now working for the Florida attorney general, advises law students to maintain as much balance as possible in their lives. "If that means keeping up with a hobby, working out, or spending time with your family—try to allocate a priority to these things. It will help you maintain a healthy perspective on things, and probably, over the long run, improve your performance in law school."

Becoming distressed and depressed doesn't have to be part of your law school experience. Here are some words of advice from those who've been there:

Stick to your plan. "Law school is a very personal experience," says Cheree Simpson, a third-year student at American University College of Law who discussed these issues in an externship class. "As a student, develop your own plan of what you want to achieve in law school, and throughout your career, and follow through with those plans."

Stay balanced. "Always take time for yourself, even when you feel as if you have no time," Simpson says. "Once you implement balance into your schedule, you will see that it will be beneficial to your well-being and your career."

Avoid negativism. Jeff Schumm, a 2000 graduate of Florida State University College of Law, notes that some students are constantly expressing negative opinions of the school, the teachers, or legal education in general. "To assist in avoiding this trap, embrace the opportunities available at school and get enthusiastically involved," he says. "This will link you with other positive thinkers."

Don't panic. It can be intimidating to be surrounded by so many bright people, feeling you have to compete. "Remember you will be fine," says professor Larry Krieger of Florida State University. "Only 10 percent can be in the top 10 percent of the class, but the other 90 percent can be just as happy and successful, or more so."

Keep grades in perspective. "You can be a C student and be respected by every judge in the county," Krieger adds. He explains that getting top grades only means you get interviewed first by some of the big-money law firms—perhaps a nice objective to shoot for, but don't let it become a desperate need.

Hang on to your values. "If you came here to help people and make a difference, stick with that and you’ll be happy," Krieger says. Too often, he says, law students let themselves become motivated primarily by money and appearance. Research shows that pursuit of such externals doesn't lead to true happiness. "If you give up your values," he says, "you'll be unhappy."